The 130th Annual Meeting of APHA

3321.0: Monday, November 11, 2002 - 4:30 PM

Abstract #52024

Private Spheres and Public Health - The Contours of Tuberculosis Surveillance Among African Americans, 1896-1915

Samuel K. Roberts, PhD, Department of History/Center for the History and Ethics of Public Health, Columbia University, 322 Fayerweather Hall MC 2519, Box 4, 1180 Amsterdam Avenue, New York, NY 10027, 212 854 6637, skr2001@columbia.edu

The paper, based on research conducted for a book on African Americans and tuberculosis, argues that, although early tuberculosis surveillance was compulsory and universal, the manner in which it was conducted was not monolithically the same among all groups. In the case of Baltimore, Maryland, mandatory reporting was initiated in 1896. By 1904, however, it was apparent that certain people were falling outside the surveillance net. In particular, the city's African-American population emerged as an imagined threat to what public health officials termed "the community." Based on mortality records, health officials estimated that the number of living black consumptives was much higher than what the registration lists reflected.

African Americans, who had already been labeled by nineteenth- and twentieth-century medicine as particularly prone to tuberculosis, and by anti-black politicians as a scourge on white society, became the target of an intense campaign to find and register consumptives among them. In this effort, the white lay public was encouraged to think of all black consumptives as incorrigible and failing to comply with the laws of hygiene. Largely excluded from industrial and professional occupations and relegated to vulnerable and low-paying service jobs, blacks were all the more susceptible to policing, since the rationale that black servants infected white employers was uncontested except by black physicians and community leaders whose protest went unheard. In the end, increased surveillance actually served to widen the mortality gap between blacks and whites and to confer upon the former a stigma of anti-social infective behavior.

Learning Objectives:

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Using History to Explore the Public in Public Policy, Part 2

The 130th Annual Meeting of APHA